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Author Topic: My ACLr reconstruction - 7 July 2010  (Read 3177 times)

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Offline zola

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My ACLr reconstruction - 7 July 2010
« on: July 13, 2010, 01:20:27 PM »
Hi there all - I have been surfing these boards now for a few months on and off to learn more about my injury, operation and hopeful recovery from those that have gone through the experience themselves..... so now I guess its time to post as I am 6 days post operation and have a few questions and also need a distraction to stop me spending on internet shopping...... (most recent purchase 3 bikinis for £169 and no holidays lined up.... why???!)

A brief biography for those that are interested..... 33 year old female, ruptured right leg ACL end of March 2010 on FIRST DAY of a ski trip. No big drama, a very unlucky fall, knee twisted and popped - knew I had done something but didn't think it was that serious. Got taken to a medical centre, after an embarassing piste- rescue, and the doctor moved my knee around a bit, took an x-ray and told me that I had busted my ACL ....although in French .... and certainly did not learn the phrase 'you have ruptured you anterior cruciate ligament' in French at school, 'Genou'/ 'Knee' yup fine but didn't exactly need a translator to tell me I'd hurt my knee (doh!) So after a bit of the doctor saying 'cruciate' in French a few times, I finally twigged and said to him... 'oh my goodness you mean like the footballlers Michael Essien and (now showing my age here) Casiraghi' and when he said 'Oui Oui Casiraghi' I had a good cry and then started to plan my comeback...................

SO here I am 3.5 months later, a new ACL courtesy of my right patella, having gone through a tough 3 months getting myself back to 'near' normal... except for the previously obligatory high heeled shoes (although quite a bit richer having saved myself 3 months of shoe shopping and if I hear one more person say ' I never realised you were that short' I will throttle them... NO YOU DIDN'T BECAUSE THE HEELS WERE DOING WHAT THEY WERE INTENDED FOR... HIDING THE TRUTH).

I had the patella graft as it was the preferred choice of my surgeon, so having swotted up somewhat and changing consultants once already I decided to go with the preferred choice of my preferred surgeon.

Op date was 7 July 2010 - went in at 7am, went down about 10am, had some Class As, woke up a few hours later and had a conversation with my consultant, which, I might add, I have no recollection whatsoever of what I said or what he said as quite frankly I was off my head on morphine. I sidetrack ('again' you think..) here but I have no idea how people become junkies as the morphine made me feel extremely sick for a good 6 or 7 hours post-op, although was never actually sick.

Stayed the evening in hospital, as in the UK it is mostly standard protocol, and was able to be discharged the next morning having been able to haul myself out of bed, wash and go to the loo independently with the aid of a leg brace (put on by the physio) and crutches.

The physio went through with me the RICE mantra and also the heel slides, ankle pumps, SLRs etc etc and set my brace to 0 degs extension and 90 degs flexion.

After a rather scary car ride home (have never liked the husband's driving - and never noticed quite how many sodding bumps are in the roads nowadays as felt every one of them - not to mention potholes that have gone 6 months untreated.....) I am here housebound having RICE'd for the last 6 days. Some pain but not too bad considering what they have done to me, taking anti-imflammatories diclofenac and a few co-codamol and have slept like a baby every night except for the first.

However..... now have a few queries and would like anyone elses opinion:

1) My quads have gone to sleep... how can I waken them?? Flexion about 80 deg manageable, have full extension but cannot FOR THE LIFE OF ME do a straight leg raise... not one since the first morning following surgery... and I have really quite strong quads from years of sport (netball, athletics, skiing, hockey, aerobics, step, pilates, tennis, spin classes, even the odd bit of pole-dancing.. recreationally I might add... mostly on hen-dos and tipsy). In fact slightly worried how asleep they are. They do twitch when I try to flex them but that's about it. Any thoughts?

2) My physio has made my first appointment 19 July (12 days post op) - does this seem late to you? What should I try to do in the meantime? Walk some more? (I can put full weight on op leg and walk with crutches)?

3) This brace - how long should I wear it? Currently in it 24/7 aside from when doing my exercises. Should it be locked when I walk or not? They didn't tell me?

4) The sexy surgical stockings - took it off my operated leg as it seemed to be making my knee and thigh more swollen. Swelling has calmed down since removed it and on my feet for say 30 mins a day. Do you reckon this is okay?? Also only wearing the 'good' leg stocking when asleep as too hot.

Anyhow - would appreciate any feedback. Feel free to ask any questions you might have about my surgery experience etc etc.

Cheers





 

Offline tez27

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Re: My ACLr reconstruction - 7 July 2010
« Reply #1 on: July 13, 2010, 01:59:59 PM »
Hi Zola great to here your experiences post op as my aclr is booked for Mon 19th July so less than a week to go for me, its interesting how everyone experience is different, from what I've been told I wont be having a brace after surgery that seems to differ from surgeon to surgeon. will be interested to hear the answers to your questiong's but cos I aint had my op yet someone else will have to help you with them.
Ahaa the loss of the heels I sympathise with you there cos that has been a big problem for me too and even though heels were actually my downfall [fell down stairs wearing high boots and buggered up my knee] I still miss them and have nothing to wear as most of my clothes need heels to look anyway half decent and only being 5ft 2 with a 6ft husband a Son whose 6ft5 and a Daughter whose 5ft8 I am a shrimp in comparison.
Look forward to reading your diary and seeing how your recovery goes
Take care Tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline zola

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Re: My ACLr reconstruction - 7 July 2010
« Reply #2 on: July 13, 2010, 03:05:19 PM »
Thanks Tez! I share your problem re the clothes issue, all my work suits the trousers are far far too long and only got a few pairs of jeans that are my actual leg length... but really its the least of our worries!

I cannot believe how you injured yourself - you poor thing! Best of luck for your operation - I will keep an eye out for your diary. Best advice I can give is not to overly analyse it. From what I understand the operation itself is fairly routine, its the recovery that is the tough bit.

Take it easy

Offline LARSknee

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Re: My ACLr reconstruction - 7 July 2010
« Reply #3 on: July 13, 2010, 04:53:10 PM »
Hi everyone and BEST WISHES to ZOLA for a speedy recovery.

I only discovered this website about a week ago,while researching recovery issues and treatment options of ACL injuries.

I fell off my road bike at the end of march and sustained a 2nd degree tear of my ACL,my surgeon however feels that the amount of laxity in my knee indicates a 3rd grade tear.
My surgery is booked for 4th Aug,I am having the LARS which may or may not need augmenting with a graft from my hamstring,depends on the amount of ACL fibre remaining intact.
I have to attend a pre op clinic 2 days prior to surgery for blood tests,ecg,chest x ray and anaesthetist check.
Have just booked 8 days in Bali as havent had holidays since jan 09,looking forward to some sunshine and warm weather as we have had record breaking cold spells here in Perth WA,15 days under 5 degrees !!
Return from hols 2 days before surgery,hopefully all relaxed and psyched up for my surgery and recovery,making a list of handy hints from all the posts i have read on here.
I have initially been given 4 weeks off post surgery,I work as private nurse for a lady who is an incomplete quadriplegic and this requires me to do wheelchair transfers in a squatted position several times a day,not sure how long post surgery i will be able to resume doing this.
I have been told i will spend 2 nights in hospital for pain relief,so hope to take my laptop and if up to it begin my post op diary.
Have been researching hiring or buying a cryocuff knee cooling system to make the process of icing my knee easier,a physio i spoke to highly recommends it.
Not sure how much swelling to expect,so trying to choose clothes options that will be comfortable but still keep me warm.
Looking forward to lots of relaxing over coffee and visiting friends and family,will still be able to drive as left knee and have an automatic.
Have a beautiful 1yr old grandaughter im looking forward to spending time with.
Of course getting my knee back to full strength and getting back my bike fitness and back on the tennis court is my top priority.
Looking forward to sharing recovery stories,and the best of luck to everyone recovering from surgery :>)

Cheers

Shelli

Offline zaiemk

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Re: My ACLr reconstruction - 7 July 2010
« Reply #4 on: July 13, 2010, 05:01:48 PM »
Hi Zola

Congrats - you have gone from injury to post op quite quickly.  And even better you remember Caisraghi :)

Quads - Achieving a full extension is very difficult for the first 5-7 days -I am at post 12 days - and doing a leg raise with full extension and engagement of quad muscles is very difficult even now.  Do the assisted leg raises from a seated position using your left leg to raise your right.  Do the passive flexing of the quads when the leg is straight -trying to pull the back of your knee down by flexing your quads.

Physio is generally 2 week post op (mine is 4 weeks for reason :'().  Its a good time to see the physio.  Keep up with the exercises they gave you at hospital.  If  you can move around a bit more, do so, but dont put yourself under too much strain - listen to the feedback from your body - if sweeling/pain increases, ease back a bit.

Brace - set at 0o and 90o is fine - when you are walking in these early stages, you'll probably voluntarily keep your leg straight.  As you develop some more flexion, the setting allows you the flexibility to bend as you need.  You dont need to lock it - if you did your PT/OS would have told you to do that.  The brace is more about ensuring you dont twist inadvertently.

The lovely fetching stockings - I was told to wear mine for the first two weeks - they want you to wear them if you are going to be still or in one position for long periods of time. Follow the advice given to you by the hospital.   (I took mine off after two days - the hairs were poking pout of them and it was disturbing site.)  As long as you are moving around regularly, you are less at risk of DVT.

Its early days - keep up with exercises - RICE - and slowly you will get greater movement and release out of the knee.  At least you have been spared the hamstring pain with the patellar graft.

Take care and good luck with the recovery - easy does it
Zaiem
 


Offline lwillson

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Re: My ACLr reconstruction - 7 July 2010
« Reply #5 on: July 13, 2010, 09:20:19 PM »
Hi Zola

Best wishes for your rehab.  Sounds like you have got yourself very well sorted and motivated to get going again.  This website is fab for those with knee issues, particularly ACL stuff - everyone here is very well in tune with your position, both physically and emotionally.   I have been surfing the internet high and low and this is by far the best place to have an informal chat with others in the same place.

Can imagine the scene with the French doctor - probably funny with hindsight, but pants at the time.  I have been there too, and even with 3 doctors in our group they couldn't work out what was wrong.  Other than suitably unhelpful comments like "ooh, tearing noises in the knee can't be good". 

I am pre ACLr surgery (but post-arthroscopy) so cannot really provide pearls of wisdom for your questions - but others on this site will furnish answers fairly quickly.  Have a look for the four ACL musketeers, a little surfing around this site and you'll see what I mean  :)

Am sure you could always contact the nurse  / surgeon / physio if really urgent.

Anyway, very best wishes for your rehab.  Those quads will come back for you.

Lawrence
30 Nov 2010 - ACLr with allograft and resected meniscus
July 2010 - MRI and athroscopy diagnosed torn ACL and multiple cartilage tears
March 2010 - ACL tear, climbing in snow
March 2009 - ACL partial tear, skiing in heavy slush
1990 - patella re-alignment surgery

Offline Snowy

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Re: My ACLr reconstruction - 7 July 2010
« Reply #6 on: July 13, 2010, 09:21:13 PM »
Hi Zola! Welcome and congrats on making it to the other side of surgery. I'm just a couple of days behind you, having had my ACLr on July 9th. Mine was a hamstring autograft, so I'm currently learning to deal with the nerve-jangling pain from the site where my hamstring tendons used to be...how is the site where they took your patellar graft feeling?

With regard to your questions, Zaiem has covered it pretty well but here are a few extra thoughts...

1) Quads - you can work on waking them up with basic quad flexes. Rest the leg flat and just try and clench the quad. My PT told me do lots of these post-surgery, although so far it's proven pretty uncomfortable as the quad pulls on the staples in my incisions. However they do get the quad firing, which will then make the other exercises easier. I definitely wouldn't be able to do an SLR right now; apart from the quad flexes I'm just working on basic extension (pushing the back of the knee into the couch) and some very gentle heel slides (these also pull at the staples, so I'm having more luck with gentle bending in a seated position.)

2) This sounds like a very reasonable timeline. I haven't set a date with my PT yet as he wants to see how I progress this week, but that fits the timeframe that both he and the OS mentioned (and seems fairly standard for other people, too, although every rehab regime is different and you'll be able to find folk starting much sooner and much later). My OS and PT both emphasized the importance of focusing on rest, ice and elevation for the first couple of weeks (combined with very gentle working of ROM) in order to ensure good wound healing and as much reduction of swelling as possible before embarking on the full PT regime.

3) & 4) I can't really speak to these as I didn't have either a brace or stockings after surgery. Protocol really varies from surgeon to surgeon so I would check in with yours and go with whatever they recommend - there will be a reason for whatever protocol they have you on.

Good luck, and keep us posted on how things go for you! The ACLr class of 2010 continues to grow.  ;D

Kay
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline Cosmicsnuffle

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Re: My ACLr reconstruction - 7 July 2010
« Reply #7 on: July 13, 2010, 09:41:27 PM »
Hi Zola!

Welcome :-)

1) SLRs - like you I had problems doing SLRs - my first PT was 6 days post op and no matter how much I puffed and grunted, squeezed and tightened ACLr leg quads would twitch but the leg wouldn't rise off the couch. Lottiefox came to see me at 10days post-op - we were messing around doing PT on the lounge floor (as you do!) and for some reason I tried an SLR lying on my back - and it worked. Somehow once I'd done that it just triggered the muscle memory. The other thing that helped was to do the SLRs with the good leg first - it kinda teaches your ACLr leg what to do (the old dog new puppy trick).

2) As Snowy says - I think your PT timing is not unusual. If you have any concerns meanwhile then don't be afraid to phone the department (OS or PT)

3,4) Like Snowy I didn't have the joys of a brace or surgical TEDs so can't help you on those.


Keep up the good work and like Snowy you'll soon be back on the slopes!
 :)



Oct 04 - torn meniscus
Dec 05 meniscal trim and debridement
Sep 09 torn ACL, kissing contusions, knee locked 30-60o
Jan 10 ACL stump debrided, lateral parrot beak meniscal tear trimmed
May 10 ACLr (Hamstring)
Aug 11 mfx (focal lesion lateral femoral condyle)
Jun 14 100k walk London-Brighton 28hrs

Offline zola

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Re: My ACLr reconstruction - 7 July 2010
« Reply #8 on: July 14, 2010, 10:52:40 AM »
Wow genuinely overwhelmed by the advice, encouragement and support offered here. Thank you very much everyone and a big hello.

I am going to have to break this update in a few separate posts as have got half way through typing my response and my laptop decides to wipe it all so bear with me.....

Shelli - g'day there downunder. Best of luck with your operation and more importantly, in the short term at least, enjoy Bali. It sounds as if you might not be able to return to your job anytime in the immediate future as it sounds rather physical? Its especially hard when somebody relies on you as well...... I guess as a private nurse you don't get sickness pay either which just adds to the downer.... Although on the positive I hear LARS is a quicker recovery time as the graft site gives us patella and hamstringers the most initial pain.

Zaeim - thanks a lot I found your advice really useful. Having had a scoot through your post op diary you seem to be making great progress. I was also shocked to see that your brace is exactly the same as mine! Being a short-arse the brace more or less covers my entire leg and makes it really uncomfortable to sit down in it with any sort of flexion in my leg. Considering perching on the loo and sofa is hard I am not looking forward to a substantial car ride.

PS Casiraghi is the reason I balled my eyes out initially... I think he had to have 9 or 10 ops and had to retire, never could quite forgive Shaka Hislop for that one (not all of us Chelsea supporters are post Roman BTW!)

 

Offline zola

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Re: My ACLr reconstruction - 7 July 2010
« Reply #9 on: July 14, 2010, 11:13:41 AM »
Lawrence - totally on your wavelength here and rung the physio this morning prior to reading your post. She said that the quad problem was quite usual, especially with the patella graft and to persist with the flat leg flexions which should trigger the muscle memory at some point or another. My knee is pretty tight and all the flexing of the quads has made it ache but its a fine line with this injury as to know when to stop pushing yourself or keep going... I am normally the 'no pain, no gain' school of philosophy but may have to re-think this over the coming months. Just out of interest... how come you had 3 doctors??

Snowy - hey lady - yes we are very close in operation times so I will continue to keep any eye on your diary to compare notes. Having read your update from yesterday, the hair wash!!! Luxury isn't it? My sister-in-law kindly came over to do mine for me yesterday evening and even, blow-dried it for me and straightened it..... bliss. I think I am going to string out the 'cannot get in the shower and wash my own hair' scenario a teeny big longer than I need to. There has to be some perks to this sofa surfing we are being obliged to do  :)

Comicsnuffle - your recovery has been inspiring - its nice to hear some positive vibes on here recently as when I first injured myself and read through a few posts it all appeared doom and gloom and made me even more depressed about my inactivity and rapidly increasing waistline. Hear what you are saying about the quads. I will persist. I ain't no quitter!!

Offline HogDog

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Re: My ACLr reconstruction - 7 July 2010
« Reply #10 on: July 14, 2010, 11:35:26 AM »
Hi Zola,

Like Snowy your stories make for an interesting read and I like the fact that you both have kept you enthusiam and humour through out this as its a great boost knowing its not all doom and gloom!

Id like to add my congratulations for coming through the op etc and good luck now on the rehab.

I have quite a few friends as Chelsea fans (unfortunately im a spurs fan) pre Roman as well and one in particular still goes on about Casiraghi so your post made me smile even though at that pont you were crying! (Sorry)

Thanks
Knee Arthroscopy 1992 - Wash out knee
Knee Arthroscopy 1995 - Remove bone debris
2007 - MCL grade 2
2010 - Torn ACL awating recon

Offline moz

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Re: My ACLr reconstruction - 7 July 2010
« Reply #11 on: July 14, 2010, 01:05:43 PM »
Hi Zola, soiunds like you are progressing well. As you know there is  different protocols for just about everyone and the safe bet I think is to be conservative and stick with what your PT and OS are telling you to do.  Just thought I would quickly put my two bobs in from what I have learnt so far (I am in my fifth week post op lars/hamstring). In the real early weeks the aim is to reduce swelling through RICE and maintain some flexibility and muscle through your exercises, your PT and surgeon should guide you through this and try to stick to their prescriptions. I have been told by my PT that the swelling is what holds alot of progress up as you bring it slightly down and then it blow up and so on and on and this hampers rehab progress, so I think that the control of swelling while maintaining the flexibililty and some muscle control is the aim. My OS appt was three weeks post op and then I was given the green light to full weight bear and walk with out crutches and brace, which I could do a few days before the appt. With regard to swelling, I would recommend to constantly take anti-inflammotaries and leave your compression gear on as much as possible, I have only just now been told to do ankle pumps to help drain swelling, that is what I have been told to do as I need to bring my sweling down.
Things will progress and you will have your good and bad days guaranteed. But keep in there and you will be fine :). Goodluck

Offline roo222

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Re: My ACLr reconstruction - 7 July 2010
« Reply #12 on: July 14, 2010, 10:26:01 PM »
Zola

Just wanted to say not to feel too bad about having Laudrup on the back of your shirt, a few seasons ago i decided getting Kezman on the back of my shirt was a good idea. (in my defence he was half decent in pre season!) ::) Since then ive not been so quick to get names on my shirts...

Sorry nothing really of value to add to this conversation apart from that, just id add to the chelsea flavour 8)

March 2010: Torn ACL and meniscus damage to right knee (football)
April 2010: Arthroscopy to partially remove meniscus
October 14th: ACLr (hamstring graft) :)

Offline LARSknee

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Re: My ACLr reconstruction - 7 July 2010
« Reply #13 on: July 15, 2010, 04:59:48 PM »
Wow genuinely overwhelmed by the advice, encouragement and support offered here. Thank you very much everyone and a big hello.

I am going to have to break this update in a few separate posts as have got half way through typing my response and my laptop decides to wipe it all so bear with me.....

Shelli - g'day there downunder. Best of luck with your operation and more importantly, in the short term at least, enjoy Bali. It sounds as if you might not be able to return to your job anytime in the immediate future as it sounds rather physical? Its especially hard when somebody relies on you as well...... I guess as a private nurse you don't get sickness pay either which just adds to the downer.... Although on the positive I hear LARS is a quicker recovery time as the graft site gives us patella and hamstringers the most initial pain.

Zaeim - thanks a lot I found your advice really useful. Having had a scoot through your post op diary you seem to be making great progress. I was also shocked to see that your brace is exactly the same as mine! Being a short-arse the brace more or less covers my entire leg and makes it really uncomfortable to sit down in it with any sort of flexion in my leg. Considering perching on the loo and sofa is hard I am not looking forward to a substantial car ride.

PS Casiraghi is the reason I balled my eyes out initially... I think he had to have 9 or 10 ops and had to retire, never could quite forgive Shaka Hislop for that one (not all of us Chelsea supporters are post Roman BTW!)

 
Hi Zola,thanks for the reply,I dont have to worry about sick pay as I am covered through my BicyclingWA insurance.
It costs $95 yearly for coverage 24/7 whenever you are riding your bike,there is only a 2 week excess then they pay 80% of weekly salary for up to a year,plus 85% of out of pocket medical expenses,and some hospital expenses.
I had 2 months off work after initial injury,and when i have surgery on 4th aug they will cover my salary again.
I am looking at purchasing a cryo cuff knee autochill to reduce swelling and speed recovery,so should be able to claim back 85% of the cost.
A friend who introduced me to road cycling last year recommended i take out the insurance,Im so glad they did. :>)
Next week will be busy cooking meals to freeze for when i come home from hospital.
Hi to everyone on here
Cheers
Shelli

Offline zaiemk

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Re: My ACLr reconstruction - 7 July 2010
« Reply #14 on: July 15, 2010, 05:37:30 PM »
Hi Zola

Answers or suggestions for your questions:

1.  Ankle pumps - I think they tend to be done without resistance, but you can loop a belt or towel round to help with pulling the toes up to improve extension and then push back against the belt/towel.  I had to do this as they overdid the nerve block on me and I couldn't lift my foot for about 30 hours post op.

2.  I cant really help you with this, although I have been taking some supplements.

3.  Returning to work - everyone's recovery is different.  The hospital should have given you a minimum six week sick note.  They do say that for sedentary work most people can return after two weeks, but this still needs to be managed as staying in position for too long will lead to stiffness, but if you commute includes walking and jostling I would take advice.  You can manage your own walking and movement, but you cant legislate for someone barging into the side of your leg with a bag.  If you do decide to go back, use the crutches as a sign that people should give you some space.  If you do go back on 4th Aug for a few hours, dont go and comeback during rush hour.

4.  Graft resilience - I would like to think that we all do something similar early on - I did.  I dont think you will have caused any damage, but try not to make any fast sharp movements and watch for bumping into stuff, stubbing your foot, over balancing and walking on uneven surfaces.  Which echoes why you also need to be careful about going back to work.

5.  Mums and their cooking - I'm no help - I love my mums cooking, its a problem that they cant appreciate how much one person can eat, and bring enough to feed you for a week.

Keep up with your exercises and ice-ing.
Zaiem